Black Spots on the Tongue: Causes and Concerns

Small black spots on the tongue?

Hello Doctor: I found a small black bump on my tongue that feels a bit strange.
At first, I thought it was something stuck to it from eating, but I can't get it off.
I tried to pull it off, but it seems to be growing on the surface and it hurts.
It looks similar to other normal-colored bumps nearby, but the only difference is that it is darker in color.
I'm not sure what it is.
Can I just leave it alone? Gina

GINA, 20~29 year old female. Ask Date: 2013/03/23

Dr. Chen Bozhang reply Family Medicine

If symptoms persist for more than two weeks, please consult an oral and maxillofacial surgeon or an otolaryngologist.

Reply Date: 2013/03/23

More Info

When you notice a black spot on your tongue, it can be concerning, especially if it feels raised and painful. There are several potential causes for this phenomenon, and understanding them can help you determine whether you need to seek medical attention.

Possible Causes of Black Spots on the Tongue
1. Black Hairy Tongue: This condition occurs when the filiform papillae (tiny bumps on the tongue) become elongated and discolored, often due to poor oral hygiene, smoking, or certain medications. The buildup of bacteria and dead cells can give the tongue a black appearance. While it is generally harmless, it can be a sign of neglect in oral care.

2. Fungal Infections: Oral thrush, caused by an overgrowth of Candida yeast, can lead to white or black patches on the tongue. This condition is more common in individuals with weakened immune systems or those who use inhaled corticosteroids without proper oral hygiene.

3. Geographic Tongue: This benign condition is characterized by irregular patches on the tongue that can appear red and may have a white border. Occasionally, these patches can take on a darker hue, leading to confusion about their nature.

4. Oral Melanotic Macule: This is a benign pigmented lesion that can appear on the tongue or other areas of the oral cavity. It is usually flat and can be brown or black. While it is not harmful, any new or changing lesions should be evaluated by a healthcare professional.

5. Trauma or Injury: If you have bitten your tongue or experienced some form of trauma, it can lead to localized bleeding or bruising, which may appear as a black spot. This is typically temporary and should resolve on its own.

6. Oral Cancer: Although less common, persistent black spots or lesions that do not heal can be a sign of oral cancer. This is particularly concerning if accompanied by other symptoms such as pain, difficulty swallowing, or changes in speech.

Should You Be Concerned?
If the black spot on your tongue is new, persistent, and accompanied by pain or other symptoms, it is advisable to seek a consultation with a healthcare professional, preferably an oral surgeon or a dentist. They can perform a thorough examination and may recommend a biopsy if there is any suspicion of malignancy.

What to Do Next
1. Maintain Oral Hygiene: Ensure you are brushing your tongue gently while brushing your teeth and using mouthwash to reduce bacteria buildup.

2. Avoid Irritants: If you smoke or consume alcohol, consider reducing or eliminating these substances, as they can exacerbate oral health issues.

3. Monitor Changes: Keep an eye on the spot. If it changes in size, color, or shape, or if you develop additional symptoms, seek medical advice promptly.

4. Consult a Professional: If the spot does not resolve within a couple of weeks or if you have any concerns, it is best to consult a healthcare provider for a definitive diagnosis and appropriate treatment.

In summary, while many causes of black spots on the tongue are benign, it is essential to monitor the situation and seek professional advice if you have any concerns. Early detection and treatment can prevent potential complications and ensure your oral health remains optimal.

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